Privacy Practices for Healthcare

Notice of Privacy Practices

Effective Date: May 1, 2026

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY.

If you have any questions about this notice, please get in touch with our privacy officer:

A2PT Physical Therapy & PhysioFit Inc.

c/o Frank Dieckman, PT.

PO Box 15310

Sarasota FL. 34277-1310

(941) 248-9591

1. Summary of Rights and Obligations Concerning Health Information. A2PT Physical Therapy & PhysioFit Inc. is committed to preserving the health information privacy of your medical records, which is required by both federal and state law. We are mandated to provide you with this notice detailing our legal duties, your rights, and our practices regarding the use and disclosure of your health information created or retained by A2PT Physical Therapy & PhysioFit Inc. Every time you visit us, we document your visit. Typically, this record includes your symptoms, examination and test results, our assessment of your condition, treatment interventions provided, and a plan for future care. We have an ethical and legal obligation to protect your health information privacy, and we will use or disclose it only in limited circumstances. Generally, we may utilize and disclose your health information to:

• Plan your care and treatment;

• Provide treatment by us or other providers;

• Communicate with referring physicians and other providers;

• Process payment from you, your health plan, or your health insurer;

• Carry out quality assessments and improve health care operations;

• Inform you of services and treatments that may be beneficial;

• Comply with regulations that require us to disclose your information.

We may also use or disclose your health information where you have authorized us to do so. While your health record belongs to A2PT Physical Therapy & PhysioFit Inc., the information within it is yours. You have the right to:

• Ensure the accuracy of your health record;

• Request confidential communication with your physician and set limits on the use and disclosure of your health information;

• Request an accounting of certain uses and disclosures of your health information we have made.

We are required to:

• Maintain the privacy of your health information;

• Provide you with this Notice of Privacy Practices detailing our legal duties and privacy practices related to your data;

• Abide by the terms of our most recent Notice of Privacy Practices;

• Notify you if we cannot agree to the requested restrictions;

• Accommodate reasonable requests for alternative communications of health information.

We reserve the right to amend our practices and make new provisions effective for all of your maintained health information. Should our practices change materially, a revised Notice of Privacy Practices will be available upon request. We will not use or disclose your medical information without your authorization, except as outlined in our most current Notice of Privacy Practices. The following sections detail our privacy practices and your rights regarding your health information in greater detail.

2. We may use or disclose your medical information in various capacities:

Treatment. We may utilize and disclose your protected health information to deliver, coordinate, and manage your rehab care. This may involve consulting with other health care providers about your treatment or referring you for further care. For example, releasing your protected health information to a referred specialist ensures they have the relevant information to diagnose and/or treat you.

Payment. We may need to use and disclose your health information for billing and collection purposes related to the services we provided. For instance, we may contact your health insurer to confirm your benefits eligibility, which may require disclosing specific details of your medical condition or expected treatment course. If you pay cash at the time of service, your protected health information will not be disclosed unless you provide written authorization. If we agree to wait for payment from your health plan or set up a payment plan, your health information may be disclosed to a collection agency or legal entities after 90 days of non-payment and without alternative arrangements.

Health Care Operations. To enhance our practice's operations, we may use and disclose your health information in evaluating care quality and outcomes, aiming to improve the health care services we provide. We may also use your data in business planning activities.

Business Associates. A2PT Physical Therapy & PhysioFit Inc. sometimes partners with third-party business associates for necessary services. We may provide your health information to these associates solely for fulfilling their responsibilities. To safeguard your health information privacy, we ensure our associates are also required to protect your data accordingly.

Appointment Reminders. We may use your medical record information to remind you of upcoming appointments, typically reaching out the day before via phone. If you prefer specific contact methods, we will work to accommodate your requests.

Treatment Options. Your health information may be utilized to inform you of alternative treatments available.

Release to Family/Friends. Our staff may, using their professional judgment, disclose relevant health information to a family member, relative, close friend, or any individual you identify regarding your care involvement or associated payments. We will give you a chance to object to those disclosures when feasible. Disclosure of minor children's health information to parents or guardians may occur unless restricted by law.

Health-Related Benefits and Services. We might share health information about health benefits or services that may interest you, including communicating during face-to-face appointments for additional products and services that might benefit your care.

Newsletters and Other Communications. Your personal information may be used to engage with you through newsletters (including electronic versions), mailings, or other means concerning treatment options, health information, disease management, wellness initiatives, or activities we participate in.

Disaster Relief. In disaster relief situations, we may disclose your health information to organizations needing it to coordinate your care or inform others of your condition and whereabouts.

Marketing. Generally, we require written authorization before using or disclosing your health information for marketing endeavors. However, we might provide nominal promotional gifts and market services during face-to-face interactions. Under no circumstance will we sell our patient lists or health information to external parties without your express written consent.

Public Health Activities. Your medical information may be disclosed for public health actions, which could include:

• Licensing and certification by public health authorities;

• Disease prevention or control measures;

• Reporting births and deaths;

• Reporting abuse or neglect;

• Notifications for individuals exposed to contagious diseases;

• Organ or tissue donation initiatives; and

• Required notifications to authorities regarding abuse, neglect, or domestic violence, under legal mandates.

Food and Drug Administration (FDA). We may disclose relevant health information to the FDA or other health regulatory agencies concerning adverse events related to products or monitoring information critical for product safety.

Workers Compensation. Your health information may be disclosed per necessary compliances regarding workers' compensation and related laws.

Law Enforcement. We may disclose your information:

• Upon court orders, subpoenas, or warrants;

• To identify or locate a suspect or material witness;

• About crime victims with specific conditions;

• If we suspect death due to criminal conduct;

• About crimes occurring within A2PT Physical Therapy & PhysioFit Inc.;

• To coroners or medical examiners;

• In emergencies, about criminal actions or potential threats;

• To authorized federal officials regarding national security investigations.

De-identified Information. We may use your health information to create "de-identified" information or share it with a business associate to do so on our behalf. De-identified health information does not identify you directly and cannot be reasonably linked back to you.

Personal Representative. If you have a personal representative, we will grant them the same access to your health information as if they were you. In the event of your passing, we may disclose your health information to an executor or administrator of your estate acting as your representative.

HLTV-III Test. Should we conduct an HLTV-III test to determine HIV exposure, we will not disclose results to anyone except you without your written consent unless otherwise legally required.

Limited Data Set. We may use and disclose a limited data set devoid of specific identifiable information for research, public health, or healthcare operations. This will only occur under a data use agreement that maintains security and restricts contact with any individual.

3. Authorization for Other Uses of Medical Information. Any uses of medical information not explicitly covered by our Notice or applicable laws can occur only with your written authorization. However, we cannot be held responsible for further disclosures made by parties authorized by you. You may revoke your authorization in writing at any time, at which point we will stop using or disclosing your medical information, except where prior actions have relied on that authorization.

4. Your Health Information Rights. You have the following rights regarding the medical information we hold:

A. Right to Obtain a Paper Copy of This Notice. You are entitled to receive a paper copy of this Notice of Privacy Practices anytime, regardless of whether you agreed to receive it electronically.

B. Right to Inspect and Copy. You can inspect and copy the medical information pertinent to decisions about your care, including medical and billing records. To do this, submit a written request to our privacy officer, who will provide a form for your request. If you request a copy, we may charge a reasonable fee covering labor, postage, and supplies, unless the information is needed for a Social Security benefits claim.

C. Right to Amend. If you believe the medical information we possess is incorrect or incomplete, you may request an amendment by submitting your written request to our privacy officer, including a supporting reason. We may deny requests based on certain factors, including if the information is not maintained by A2PT Physical Therapy & PhysioFit Inc.

D. Right to an Accounting of Disclosures. You may request an accounting of disclosures of your health information. This accounting will not include certain types of disclosures, including those for treatment, payment, health care operations, or that were made with your authorization.

E. Right to Request Restrictions. You may request restrictions on certain medical information we use or disclose. Your request must be written and specify which information you want to limit and how.

F. Right to Request Confidential Communications. You can request confidential communication regarding medical matters in specific ways or locations, without having to disclose your reasons. We will accommodate all reasonable requests for such communications.